• 대한핵의학회지
• /
• 제28권1호
• /
• pp.52-61
• /
• 1994

Background : The demand for refinement in noninvasive and quantitative assessment of left ventricular (LV) function is increasing. Purpose : To assess normal values of left ventricular functional parameters during both systole and diastole by scintigraphic method using computerized triple-head gamma camera and to evaluate correlations between these parameters. Methods : ECG gated blood pool scan with $^{99m}Tc$-Human serum albumin was performed in 94 normal Korean subjects. Ejection fraction (EF), systolic parameters [peak emptying rate (PER), average emptying rate (AER), time to peak emptying rate (TPER)], and diastolic parameters [peak filling rate (PFR), average filling rate (AFR), time to peak filling rate (TPFR)] were obtained by analysis of LV time-activity curve, the correlation of these parameters to the age and sex, and the correlation between these parameters were evaluated. Results : 1) Mean value of ejection fraction in study subjects was $59.6{\pm}5.25%$ and showed no significant correlation to age (r=-0.08) and sex but showed most pronounced correlation to PFR (r=0.46, p<0.001), PER (r=0.41, p<0.001), AFR (r=0.34, p<0.001) and AER (r=0.28, p<0.01). 2) Mean values of systolic parameters were as follows: $PER=3.22{\pm}0.50$ end-diastolic volume/sec, $AER=2.22{\pm}0.45$ end-diastolic volume/sec, $TPER=103.5{\pm}29.30$ msec. They showed no significant correlation to age and sex. 3) Mean values of diastolic parameters were as follows: $PFR=2.71{\pm}0.51$ end-diastolic volume/sec, $AFR=1.83{\pm}0.44$ end-diastolic volume/sec, $TPFR=132.1{\pm}33.45$ msec. They showed strong correlation to age (r=0.70, -0.64, 0.37, p<0.001). Conclusions : Left ventricular functional parameters in normal Korean subjects were obtained reliably by computerized scintigraphic method and may be applied to the evaluation of cardiac function in diseased patients.

• 대한핵의학회지
• /
• 제37권4호
• /
• pp.207-218
• /
• 2003

Myocardial perfusion imaging has been increasingly used to provide prognostic data and guidance on the choice of appropriate management of patients with known or suspected coronary artery disease. The electrocardiogram gated myocardial SPECT program is corning into wide use with an advent of $^{99m}Tc-labeled$ tracers and an improvement of SPECT machines. The gated technique permits measurement of important cardiac prognostic indicators without any further discomforts or radiation burden in patients underwent standard myocardial perfusion SPECT. In addition, gated study significantly improves diagnostic yield by reducing the number of borderline interpretations and could find myocardial stunning and viable myocardium. Gated single photon emission computed tomography (SPECT) imaging allows the automated calculation of end-diastolic volume, end-systolic volume, ejection fraction, myocardial mass and the assessment of regional wall motion and thickening, and it have dramatically improved assessment of coronary artery disease in routine nuclear practice. This allows the simultaneous assessment of both perfusion and function within the same acquisition, and serves as a cost-effective technique for providing more diagnostic data with fewer diagnostic tests. Because the diagnostic and prognostic power derived from knowledge of left ventricular function can be added to that provided by assessing myocardial perfusion, gated SPECT imaging has rapidly gained widespread acceptance and is now used on a routine clinical basis in a growing number of laboratories, including South Korea. The gated SPECT technique for measurement of left ventricular parameters has been validated against a variety of well established techniques. In this work, overview of gated myocardial perfusion SPECT focus on functional parameters is presented.

• 약학회지
• /
• 제41권6호
• /
• pp.829-836
• /
• 1997

Studies on the effect of quinones on cardiac function has been conducted with normal hearts. But not with injured hearts, I.e. ischemia/reperfusion-injured heart. Quinone compounds are known to produce oxygen free radicals during metabolism, and for this reason, quinones are implicated in the aggravation of ischemia/reperfusion injury or cardioprotection, as in the case of ischemic preconditioning depending on the experimental conditions. The present study was carried out to examine the effect of 2-chloro-3-(4-cyanophenylamino)-1.4-naphthoquinone (NQ-Y15) on cardiac function of ischemic/reperfused and normal rat hearts. In isolated perfused hearts, various functional parameters such as left ventricular developed pressure (LVDP), left ventricular end-diastolic pressure (EDP) and maximum positive and negative dP/dt ($[\pm}dP/dt_{max}$), time to contracture, heart rate (HR) and coronary flow rate (CFR) were measured before and 30 min after dosing and following 25 min ischemia/30min reperfusion. NQ-Y15 increased LVDP, +dP/$d_{max}$and -dP/$dt_{min}$ by 18%. 30%, and 40%, respectively. There were no significant changes in other haemodynamic parameters. After ischemia/reperfusion injury, pretreatment with NQ-Y15 induced a significant decrease in LVDP and $[\pm}dP/dt_{max}$, but an increase in EDP. LDH-release was not significantly increased. These results suggested that NQ-Y15 may augment the ventricular contractility but it makes hearts more vulnerable to ischemia/reperfusion injury.

• 대한핵의학회지
• /
• 제20권2호
• /
• pp.39-45
• /
• 1986

Resting gated blood pool scan was used to derive left ventricular functional changes in normals (N=13, mean age=43) and in patients with coronary artery disease (N=50, mean age=53). Peak filling rates, average filling rates, and ejection fractions were significantly depressed in coronary artery disease. (p<0.0005, each other). And in coronary artery disease with normal ejection fraction (N=21), peak filling rates and average filling rates were depressed also, and peak filling rates of coronary artery disease with normal ejection fraction were abnormal in 61.2% and average fillin rates were abnormal in 71.4%. It appears that (1) resting peak filling rates and average filling rates were sensitive and easily obtainable parameters of the diastolic dysfunction assosiated with coronary artery disease, (2) a significant proportion of coronary artery disease patients without any evidence of abnormal systolic function have depressed resting peak filling rates and average filling rates of the left ventricle.

• Clinical and Experimental Pediatrics
• /
• 제52권3호
• /
• pp.339-345
• /
• 2009

목 적 : 이 연구의 목적은 소아에서 고식적 심초음파와 조직 도플러 영상을 이용하여 측정한 지표들의 심장 주기 시간에 따른 변화를 알아보기 위함이다. 방 법 : 2006년 7월부터 2007년 6월까지 강릉아산병원에서 심장초음파를 시행한 해부학적으로 정상 심장을 가진 총 18명의 소아들을 대상으로 본 연구를 시행하였다. 심첨 4방 단면도에서 이완기 승모판 유입 최고 혈류 속도 E, A와 승모판륜의 외측 끝단 및 심실 중격 끝단에서 조직 도플러 영상으로부터 s',e',a'과 함께 각각의 심장 주기 시간을 측정하였다. 모든 측정은 연속된 6-18 심장 주기 동안 이루어졌으며, 심장 주기 길이와 각 지표들 간의 연관성을 조사하였다. 결 과 : 평균 나이는 $3.6{\pm}0.5$세(남:여=8:10)이었다. 심장 주기 시간과 Lat s', Lat a', Sep s', Sep e', Sep a'은 음의 상관관계를 보였다(P<0.01). 심장 주기 시간과 E/A, Lat e'/a', Sep e'/a'은 양의 상관 관계를 보였다(P<0.01). 그러나 E, Lat e'은 통계학적으로 유의한 상관관계를 보이지 않았다(P=0.229, 0.221). 결 론 : 본 연구로 심장 주기 시간의 변화에 따라 좌심실 기능을 나타내는 지표들이 변화함을 알 수 있었다. 따라서 소아에서 정상치를 결정함에 있어 이러한 변화를 고려하여야 한다.

• Clinical and Experimental Pediatrics
• /
• 제59권4호
• /
• pp.190-195
• /
• 2016

Purpose: Severe aplastic anemia (SAA), a fatal disease, requires multiple transfusion, immunosuppressive therapy, and finally, hematopoietic stem cell transplantation (HSCT) as the definitive treatment. We hypothesized that iron overloading associated with multiple transfusions and HSCT-related complications may adversely affect cardiac function. Left ventricular (LV) function was assessed in children after HSCT for SAA. Methods: Forty-six consecutive patients with a median age of 9.8 years (range, 1.5-18 years), who received HSCT for SAA and who underwent comprehensive echocardiography before and after HSCT, were included in this study. The data of LV functional parameters obtained using conventional echocardiography, tissue Doppler imaging (TDI), and speckle-tracking echocardiography (STE) were collected from pre- and post-HSCT echocardiography. These data were compared to those of 40 age-matched normal controls. Results: In patients, the LV ejection fraction, shortening fraction, end-diastolic dimension, mitral early diastolic E velocity, TDI mitral septal E' velocity, and STE LV longitudinal systolic strain rate (SSR) decreased significantly after HSCT. Compared to normal controls, patients had significantly lower post-HSCT early diastolic E velocity and E/A ratio. On STE, patients had significantly decreased LV deformational parameters including LV longitudinal systolic strain (SS), SSR, and diastolic SR (DSR), and circumferential SS and DSR. Serum ferritin levels showed weak but significant correlations (P<0.05) with LV longitudinal SS and SSR and circumferential SS and DSR. Conclusion: Subclinical LV dysfunction is evident in patients after HSCT for SAA, and was associated with increased iron load. Serial monitoring of cardiac function is mandatory in this population.

• Korean Journal of Radiology
• /
• 제24권12호
• /
• pp.1221-1231
• /
• 2023

Objective: To clinically validate the feasibility and accuracy of cine images acquired through the multitasking method, with no electrocardiogram gating and free-breathing, in measuring left ventricular (LV) function indices by comparing them with those acquired through the balanced steady-state free precession (bSSFP) method, with multiple breath-holds and electrocardiogram gating. Materials and Methods: Forty-three healthy volunteers (female:male, 30:13; mean age, 23.1 ± 2.3 years) and 36 patients requiring an assessment of LV function for various clinical indications (female:male, 22:14; 57.8 ± 11.3 years) were enrolled in this prospective study. Each participant underwent cardiac magnetic resonance imaging (MRI) using the multiple breath-hold bSSFP method and free-breathing multitasking method. LV function parameters were measured for both MRI methods. Image quality was assessed through subjective image quality scores (1 to 5) and calculation of the contrast-to-noise ratio (CNR) between the myocardium and blood pool. Differences between the two MRI methods were analyzed using the Bland-Altman plot, paired t-test, or Wilcoxon signed-rank test, as appropriate. Results: LV ejection fraction (LVEF) was not significantly different between the two MRI methods (P = 0.222 in healthy volunteers and P = 0.343 in patients). LV end-diastolic mass was slightly overestimated with multitasking in both healthy volunteers (multitasking vs. bSSFP, 60.5 ± 10.7 g vs. 58.0 ± 10.4 g, respectively; P < 0.001) and patients (69.4 ± 18.1 g vs. 66.8 ± 18.0 g, respectively; P = 0.003). Acceptable and comparable image quality was achieved for both MRI methods (multitasking vs. bSSFP, 4.5 ± 0.7 vs. 4.6 ± 0.6, respectively; P = 0.203). The CNR between the myocardium and blood pool showed no significant differences between the two MRI methods (18.89 ± 6.65 vs. 18.19 ± 5.83, respectively; P = 0.480). Conclusion: Multitasking-derived cine images obtained without electrocardiogram gating and breath-holding achieved similar image quality and accurate quantification of LVEF in healthy volunteers and patients.

• The Korean Journal of Physiology and Pharmacology
• /
• 제3권3호
• /
• pp.329-337
• /
• 1999

Thyroid hormone-induced cellular dysfunctions may be associated with changes in the intracellular $Ca^{2+}$ concentration. The ryanodine receptor, a $Ca^{2+}$ release channel of the SR, is responsible for the rapid release of $Ca^{2+}$ that activates cardiac muscle contraction. In the excitation-contaction coupling cascade, activation of ryanodine receptors is initiated by the activity of sarcolemmal $Ca^{2+}$ channels, the dihydropyridine receptors. In hyperthyroidism left ventricular contractility and relaxation velocity were increased, whereas these parameters were decreased in hypothyroidism. The mechanisms for these changes have been suggested to include alterations in the expression and/or activity levels of various proteins. In the present study, quantitative changes of ryanodine receptors and the dihydropyridine receptors, and the functional consequences of these changes in various thyroid states were investigated. In hyperthyroid hearts, $[^3H]ryanodine$ binding and ryanodine receptor mRNA levels were increased, but protein levels of ryanodine were not changed significantly. However, the above parameters were markedly decreased in hypothyroid hearts. In case of dihydropyridine receptor, there were a significant increase in the mRNA and protein levels, and [3H]nitrendipine binding, whereas no changes were observed in these parameters of hypothyroid hearts. Our findings indicate that hyperthyroidism is associated with increases in ryanodine receptor and dihydropyridine receptor expression levels, which is well correlated with the ryanodine and dihydropyridine binding. Whereas opposite changes occur in ryanodine receptor of the hypothyroid hearts.

• Journal of Chest Surgery
• /
• 제32권9호
• /
• pp.773-780
• /
• 1999

연구배경: 적출 흰쥐 심장에서 짧은 기간 동안 칼슘 파라독스를 반복하면(칼슘결핍 및 재투여에 의한 칼슘 전처치, calcium-free preconditioning-calcium depletion and repletion)하면 후속 되는 보다 긴 기간 동안의 허혈에 대하여 재관류시 심장기능 회복 증가, 괴사크기의 감소 등 허혈성 전처치에서 나타나는 것과 유사한 심근보호 효과가 있음이 최근 보고되어 있다. 본 실험에서는 적출 토끼 심장을 이용하여 칼슘결핍용액으로 전처치할 경우 ischemic preconditioning(이하 IP)와 유사한 심근보호 효과가 나타나는가의 유무를 기능 및 형태학적 측면에서 확인하고자 하였다. 대상 및 방법: 체중 1.5∼2.0 kg의 건강한 흰토끼(New Zealand White rabbit)의 적출 심장을 이용하여 Langendorff 방법에 따라 관류하여 일정한 기준치가 유지되면 전체 허혈(5분)-재관류(10분) 1회 실시로 IP를 유도하고 45분 동안 전체허혈후 120분 동안 재관류하였다(IP군, n=7). 대조군(n=7)에서는 IP없이 45분 동안 전체허혈후 120분 동안 재관류를 실시하였다. 칼슘결핍용액 투여 전처치군(n=7)에서는 5분 동안 칼슘결핍용액을 투여 후 10분 동안 칼슘이 포함된 관류액으로 관류하고 45분 동안 허혈을 실시한 후 120분 동안 재관류하였다. 허혈후 재관류 기간 동안 좌심실 기능, 관혈류 등을 측정하였으며 심근괴사 크기는 1% tetrazolium으로 염색하여 형태계측 하였다. 결과는 분산분석(ANOVA)을 실시하여 유의성이 있다고 판정되면 Tukey's post-hoc test로 검정하였다. 결과: 45분 동안 허혈후 LVDP, dP/dt, 관혈류 등은 다른 실험군에 비하여 IP군에서 현저히 증가하였으나 칼슘결핍용액 투여 전처치군에서는 오히려 허혈 대조군에 비하여 현저히 감소하였다. 그러나 칼슘결핍용액 투여 전처치군에서는 IP군에서와 같이 허혈 대조군에 비하여 심근괴사 범위가 현저히 감소되었다. 결론: 이상의 결과로 적출 관류 토끼 심장에서 칼슘결핍용액 투여로 전처치할 경우 후속된 장시간 동안의 허혈에 대하여 좌심실기능 회복 증가는 기대할 수 없으나 심근괴사 범위 한정 등의 보호효과가 있는 것으로 생각된다.

• The Korean Journal of Physiology and Pharmacology
• /
• 제23권2호
• /
• pp.103-111
• /
• 2019

The study is to investigate effects of andrographolide on experimental autoimmune myocarditis (EAM). Lewis rats were immunized on day 0 with porcine cardiac myosin to establish EAM. The EAM rats were treated with either andrographolide (25, 50, 100 mg/kg/day) or vehicle for 21 days. An antigen-specific splenocytes proliferation assay was performed by using the cells from control rats immunized with cardiac myosin. Survival rates, myocardial pathology and myocardial functional parameters (left ventricle end-diastolic pressure, ${\pm}dP/dt$ and left ventricular internal dimension) of EAM rats received andrographolide were significantly improved. Andrographolide treatment caused an decrease in the infiltration of $CD3^+$ and $CD14^+$ positive cells in myocardial tissue. Moreover, andrographolide treatment caused a reduction in the plasma levels of tumor necrosis factor-alpha, interleukin-17 (IL-17) and myosin-antibody, and an increase in the level of IL-10 in EAM rats. Oral administration of andrographolide resulted in the decreased expression of p-PI3K, p-Akt without any change of PI3K and Akt. Further results indicate andrographolide significantly inhibited myosin-induced proliferation in splenocytes, and this effect was inhibited by co-treatment of SC79 (Akt activator). Our data indicate andrographolide inhibits development of EAM, and this beneficial effect may be due to powerful anti-inflammatory activity and inhibitory effect on PI3K/Akt pathway.